Last reviewed
2026-02-07
Workflow pack
Headache red-flag and disposition workflow
Point-of-care workflow to distinguish high-risk headache presentations from structured outpatient management.
Trust and governance
Use only within this workflow's defined scope and exclusions.
Clinical owner
Family Medicine Editorial Team
Risk tier
Medium
Review cadence
Every 6 months
Next due 2026-08-07
Review status
Current
Scope limits
Initial outpatient headache assessment when immediate life-threatening causes are not obvious at triage.
Exclusions (escalate/redirect)
- Thunderclap headache or major neurologic deficit requiring emergency pathway.
- Meningeal signs or altered consciousness requiring urgent hospital care.
References
Escalate-now emphasis (medium-risk workflow)
Treat red-flag findings as urgent. Escalate the care pathway early if concern persists or follow-up reliability is uncertain.
At a glance
Rapid decision framing for in-visit use. Educational only; always apply clinical judgment.
Immediate actions
- Characterize onset pattern, severity, and associated neurologic/systemic symptoms.
- Check blood pressure and focused neurologic examination at baseline.
- Identify whether immediate emergency escalation criteria are present.
Red flags / escalate now
- Thunderclap onset, focal neurologic deficit, seizure, or altered mental status.
- Fever with meningeal features or rapidly progressive neurologic symptoms.
- Persistent severe headache with unstable vital signs or escalating concern.
First-line plan
- Use outpatient symptomatic strategy only after red flags are actively excluded.
- Limit low-value imaging when no concerning features are present.
- Align treatment and follow-up interval with risk and reliability of reassessment.
Follow-up and monitoring
- Reassess quickly if symptom trajectory deviates from expected improvement.
- Escalate when new neurologic findings or severe progression emerge.
- Document return precautions and thresholds for urgent reassessment.
Condition guidance
Prescribing aids
Referral checklists
Tools and calculators
Return precautions (patient script)
Suggested plain-language wording for safety-net counseling:
If symptoms get worse, new warning signs appear, or you cannot follow the plan from this visit, seek urgent care now.
- Use with the specific red flags listed on this page.
- Confirm follow-up timing and where to go after-hours.
- Document that return precautions were reviewed and understood.
Visit-close checklist
- Document disposition, rationale, and unresolved diagnostic uncertainty.
- Give explicit return precautions and follow-up timeline before ending visit.
- Attach a relevant handout when available to reinforce adherence and safety-netting.